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Zunehmend werden Therapien aus der traditionellen chinesischen Medizin (TCM) im Rahmen der integrativen Onkologie in westliche Behandlungskonzepte integriert. Im Mittelpunkt stehen die Minderung von Nebenwirkungen der onkologischen Behandlung, eine Verbesserung der Lebensqualität, die Förderung einer gesunden Lebensweise, zudem die Kräftigung des Patienten. Für eine Reihe von TCM-Verfahren ist die Evidenzlage gut. Besonders für Akupunktur/Akupressur zur Linderung von Schmerzen (bedingt durch Chemotherapie, Aromatasehemmer oder die Tumorerkrankung selbst) liegen gute Daten vor. Schlaf, Kognition und menopausale Symptome lassen sich ebenfalls durch Akupunktur/Akupressur bessern. Ginseng gegen Fatigue und Ingwer gegen Übelkeit können als Einzelpräparate versucht werden. Die evidenzbasierte Medizin hat auch in der TCM die Forschung angetrieben. Mittlerweile liegen methodisch hochwertige Studienergebnisse vor, die eine kritische Betrachtung wert sind.

Excitation-energy transfer is a key step in processes such as photosynthesis that convert light into other forms of energy. Time-dependent density functional theory (DFT) in real time is ideal for the first-principles simulation of such processes due to its computational efficiency. We here demonstrate how real-time DFT can be used for analyzing excitation-energy transfer from first-principles. We discuss several measures of energy transfer that are based solely on the time-dependent density, are well founded in the DFT framework, allow for intuitive understanding and visualization, and reproduce important limiting cases of an analytical model. We demonstrate their usefulness in calculations for model systems, both with static nuclei and in the context of DFT-based Ehrenfest dynamics.

Nanoalloys of gold and platinum show special chemical qualities. As catalysts, for example, they are superior to pure Au and Pt nanoparticles under rather different experimental conditions. We demonstrate that combining Au and Pt leads to an advantageous combination of properties: The Pt component contributes a high density of states close to the Fermi level, which can promote chemical activity. The Au component increases the atomic mobility, which can allow the particles to structurally adapt to different chemical situations and adsorbates. Special catalytic properties of Au–Pt nanoparticles are thus expected based on general considerations, that is, inherent properties of the Au and Pt component, respectively.

AbstractObjective:The 21-gene assay (OncotypeDX Breast Cancer Test (Genomic Health Inc., Redwood City, CA)) is a well validated test that predicts the likelihood of adjuvant chemotherapy benefit and the 10-year risk of distant recurrence in patients with ER, HER2− early-stage breast cancer. The aim of this analysis was to evaluate the cost-effectiveness of using the assay to inform adjuvant chemotherapy decisions in Germany.Methods:A Markov model was developed to make long-term projections of distant recurrence, survival, quality-adjusted life expectancy, and direct costs for patients with ER, HER2−, node-negative, or up to 3 node-positive early-stage breast cancer. Scenarios using conventional diagnostic procedures or the 21-gene assay to inform treatment recommendations for adjuvant chemotherapy were modeled based on a prospective, multi-center trial in 366 patients. Transition probabilities and risk adjustment were based on published landmark trials. Costs (2011 Euros (€)) were estimated from a sick fund perspective based on resource use in patients receiving chemotherapy. Future costs and clinical benefits were discounted at 3 annually.Results:The 21-gene assay was projected to increase mean life expectancy by 0.06 years and quality-adjusted life expectancy by 0.06 quality-adjusted life years (QALYs) compared with current clinical practice over a 30-year time horizon. Clinical benefits were driven by optimized allocation of adjuvant chemotherapy. Costs from a healthcare payer perspective were lower with the 21-gene assay by ∼€561 vs standard of care. Probabilistic sensitivity analysis indicated that there was an 87 probability that the 21-gene assay would be dominant (cost and life saving) to standard of care.Limitations:Country-specific data on the risk of distant recurrence and quality-of-life were not available.Conclusions:Guiding decision-making on adjuvant chemotherapy using the 21-gene assay was projected to improve survival, quality-adjusted life expectancy, and be cost saving vs the current standard of care women with ER, HER2− early-stage breast cancer.

Predicting the polarizabilities of extended conjugated molecules with semilocal functionals has been a long-standing problem in density functional theory. These difficulties are due to the absence of a term in the typical semilocal Kohn−Sham exchange potentials that has been named “ultranonlocal”. Such a term should develop in extended systems when an external electric field is applied, and it should counteract the field. We calculate the polarizabilities of polyacetylene molecules using the recently developed extended Becke−Johnson functional. Our results show that this functional predicts the polarizabilities with much better accuracy than typical semilocal functionals. Thus, the field-counteracting term in this functional, which is semilocal in the Kohn−Sham orbitals, can realistically describe real molecules. We discuss approaches of constructing an energy functional that corresponds to this potential functional, for example, via the Levy−Perdew virial relation.

The insulin-like growth factor 1 (IGF1) and its binding protein IGFBP3 (insulin-like growth factor binding protein 3) play a pivotal role during the growth and development of tissues. The purpose of this study was to evaluate the influence of anthracycline- and taxane-containing adjuvant chemotherapy in breast cancer patients on the circulating plasma levels of IGF1 and its main binding protein, IGFBP3. This investigation was part of a prospective randomized phase III study in which breast cancer patients were treated with either conventional or dose-intensified adjuvant chemotherapy. The factors were quantified in the plasma of 151 patients with a commercially available sandwich enzyme immunoassay. Before therapy, both parameters were within the normal range in most patients (n=145 and n=144). After therapy, both factors had increased significantly by 29% (IGF1) and 19% (IGFBP3), with the highest increase being observed in the dose-intensified group. Correlations with patient and tumor characteristics revealed a relatively higher increase in both parameters in premenopausal patients, patients with lower-grade tumors, more positive lymph nodes, larger tumor volume, and positive hormone receptor status. No correlation was found with the HER2 expression of the tumors.

Abstract:: The static electric dipole polarizability of Na N clusters with even N has been calculated in a collective, axially averaged and a three-dimensional, finite-field approach for , including the ionic structure of the clusters. The validity of a collective model for the static response of small systems is demonstrated. Our density functional calculations verify the trends and fine structure seen in a recent experiment. A pseudopotential that reproduces the experimental bulk bond length and atomic energy levels leads to a substantial increase in the calculated polarizabilities, in better agreement with experiment. We relate remaining differences in the magnitude of the theoretical and experimental polarizabilities to the finite temperature present in the experiments.

Aims: Studies on the value of peritoneal tumour cell dissemination for prognosis in gastric cancer using various methods to detect tumour cells have produced conflicting conclusions. We studied the incidence and prognostic relevance of microscopic intraperitoneal tumour cell dissemination in gastric cancer, comparing conventional and immunocytological detection. Methods: Peritoneal wash-outs of 111 consecutive gastric patients without overt peritoneal carcinomatosis, including 75 curatively resected patients, were studied. Sixty patients with benign disorders served as controls. 100 ml of warm NaCl 0.9% was instilled intraoperatively and 20 ml was reaspirated. The specimens were stained peri-operatively with H&E. In the last 47 patients (30 of whom were curatively resected) additional immunostaining with the HEA-125 antibody was performed. The results of cytology were correlated with the TNM categories and with post-operative follow-up. Results: Of the patients, 42.3% and 48.9% were positive when conventional and immunocytological staining were employed, respectively. Conventional cytology was significantly associated with the pT and M categories. Immunocytology was significantly associated with the pT, pN and M caterogies. In four of 30 curatively resected patients (13.3%), the results of conventional and immunocytology were different. Three patients with positive immunocytology but negative conventional cytology died during follow-up (median follow-up 45.3 months), whereas one patient with positive conventional but negative immunocytology is still alive. In an univariate analysis 4 years post-surgery, positive immunocytology was significantly associated with an unfavourable prognosis in patients with curatively resected gastric cancer. While only 28.6% (six of 21) of the patients with negative immunocytology had died, this proportion increased to 77.8% (seven of nine) with positive immunocytology (P=0.018). The mean survival of negative vspositive patients amounted to 1205±91 vs772±147 days (P=0.007). In contrast, in conventional cytology we found no significantly different survival time between negative and positive patients. Conclusions: Immunocytology seems to be superior to conventional cytology and should be preferred.